International adoption: what is fact, what is fiction, and what is the future?

Despite the popularity of international adoption in North America and Western Europe as a means to build a family, the knowledge of health care professionals is often limited regarding the historical context of this phenomenon as well as the motivations and process experienced by adoptive parents. Although international adoption is viewed as an acceptable if not admirable method of forming kinships in accepting countries, opinions in the international community are mixed. Whether international adoptions increase or are drastically curtailed depends on addressing the misgivings that many countries have about placing their children abroad. Concerns center in two broad areas: sensitivity toward preservation of family and culture and whether the process has sufficient integrity to act in the best interests of children and birth parents.